Provider Demographics
NPI:1982649869
Name:CARRINGTON SOUTH HEALTHCARE CENTER
Entity Type:Organization
Organization Name:CARRINGTON SOUTH HEALTHCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:FEMIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-270-7041
Mailing Address - Street 1:3666 MAHONING AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515
Mailing Address - Country:US
Mailing Address - Phone:330-270-7041
Mailing Address - Fax:330-793-3103
Practice Address - Street 1:850 E MIDLOTHIAN BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502
Practice Address - Country:US
Practice Address - Phone:330-788-3038
Practice Address - Fax:330-788-1806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4293314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0801225Medicaid
OH365795Medicare ID - Type Unspecified